Olfaction in nasal polyp patients after Reboot surgery: an endotype-based prospective study
Sara Costa Gomes1, Tim Delemarre2, Gabriele Holtappels2
1Otorhinolaryngology and Ophthalmology Department, Faculty of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil.
Summary
Type-2 inflammation in olfactory mucosa is linked to smell loss in chronic rhinosinusitis with nasal polyps (CRSwNP). Reboot surgery significantly improved smell in CRSwNP patients by reducing inflammation.
Area of Science:
- Otolaryngology
- Immunology
- Rhinology
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition affecting the upper airway.
- Olfactory dysfunction is a common and debilitating symptom in CRSwNP patients.
- Understanding the inflammatory profiles of the olfactory mucosa is crucial for developing targeted treatments.
Purpose of the Study:
- To identify and compare biomarkers in the olfactory mucosa and nasal polyps of CRSwNP patients versus control subjects.
- To evaluate the impact of Reboot surgery on olfactory function over a 6-month period in CRSwNP patients.
Main Methods:
- A cohort study involving 16 CRSwNP patients and 20 controls.
- Analysis of olfactory mucosa, nasal polyps, and inferior turbinate samples for inflammatory biomarkers (e.g., IL-4, IL-5, IL-17) using Luminex and Unicap 100.
- Olfactory function assessment using Extended Sniffin' tests pre-surgery and at 1, 3, and 6 months post-Reboot surgery.
Main Results:
- Type-2 inflammatory markers were significantly elevated in CRSwNP olfactory mucosa and polyp tissues compared to controls.
- Reboot surgery led to significant improvements in olfactory function (TDI scores) starting at 1 month post-surgery, sustained for 6 months.
- Type-2 inflammation in nasal polyps correlated with reduced smell/taste pre-surgery, with improvement post-surgery. Type-3 inflammation in olfactory mucosa was linked to better pre-surgery smell but less improvement after surgery.
Conclusions:
- Type-2 inflammation in the olfactory mucosa is a key factor contributing to smell loss in CRSwNP.
- Reboot surgery, by removing inflamed sinus mucosa, offers a significant therapeutic benefit for improving olfactory function in CRSwNP patients.
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